Method of evaluating corpus luteum function by recurrently evaluating progesterone non-serum bodily fluids on multiple days

ABSTRACT

Disclosed herein are methods, for use in association with specially configured devices, systems, and kits, for performing immunoassay tests to detect for at least progesterone or analytes of progesterone on a sample in association with diagnosing problems and issues associated with corpus luteum functionality. The immunoassay devices and methods may be used in conjunction with diagnostic reader systems and/or a base unit for obtaining a sensitive read-out of the immunoassay results. The immunoassay devices and methods may utilize a competitive binding-like assay and a sandwich binding assay to detect at least progesterone or analytes of progesterone in a sample.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part application of U.S. Non-provisional patent application Ser. No. 16/544,554, filed on Aug. 19, 2019, which is a conversion of U.S. Provisional Patent Application No. 62/720,953, filed on Aug. 22, 2018, the entire contents of said applications are hereby incorporated by reference. This application is also a continuation-in-part of U.S. Non-provisional patent application Ser. No. 15/974,229 filed May 8, 2018, which is a conversion of U.S. Provisional Application No. 62/503,223 filed May 8, 2017; and U.S. Non-provisional patent application Ser. No. 15/900,794, filed Feb. 20, 2018, which is a conversion of U.S. Provisional Application No. 62/460,307 filed Feb. 17, 2017, the entire contents of said applications are hereby incorporated by reference. This application is also a continuation-in-part of U.S. Non-provisional patent application Ser. No. 16/381,229 filed Apr. 11, 2019, which is a national stage application of PCT Application No. PCT/US18/68027, filed Dec. 28, 2018, which is a PCT application claiming priority to U.S. Provisional Application No. 62/611,467 filed Dec. 28, 2017, the entire contents of said applications are hereby incorporated by reference.

FIELD OF THE INVENTION

The present invention relates to the field of hormone diagnostics. More specifically, the present invention relates to urine based lateral flow assays for the detection of hormones relevant to the corpus luteum and methods of interpretation and digital quantification thereof.

BACKGROUND OF THE INVENTION

The Corpus Luteum is a mass of cells that forms in an ovary. During ovulation, an egg is released from a dominant follicle. Following the release of the egg and subsequent fertilization, the follicle seals itself off and forms the Corpus Luteum. The Corpus Luteum produces the hormone progesterone during the luteal phase and during early pregnancy. The luteal phase is the part of the menstrual cycle that occurs after ovulation. It typically lasts 12-16 days, during time which the Corpus Luteum functions. Following conception, the Corpus Luteum functions to produce progesterone until the placenta can produce adequate levels to sustain the pregnancy, which usually occurs between 7 and 9 weeks of pregnancy. Progesterone is essential during early pregnancy because it allows the uterus to grow without having contractions, stabilizes the lining of the uterus, and improves blood flow and oxygen supply.

The Corpus Luteum a key anatomical structure associated with menstrual cycle timing. Women often attempt to chart their menstrual cycles with the aid of home use urine or saliva tests configured to detect Luteinizing Hormone (LH). However, the presence of LH only predicts the onset of ovulation and only indicates one portion of the menstrual cycle. The presence of LH does not confirm that the Corpus Luteum is functioning properly to actually release an egg. Only the corresponding release of progesterone beyond a threshold level indicates that an egg has been released. It would therefore be desirable to have an efficient and accurate method to track progesterone non-invasively and without delays associated with third party review of testing results to better understand menstrual cycle timing and Corpus Luteum functionality.

To accurately chart an entire menstrual cycle, a woman must understand the ovulation date as indicated by strips that detect for the presence of lutenizing hormone, counting days from the date of beginning menstruation, or measuring basal body temperature, for instance. Therefore, a progesterone test that does not deliver results on the same day of the test (i.e. a test that requires delivery of a sample to a lab) is not practical to allow a woman to utilize a method to measure and track her progesterone on a daily basis. The excessive waiting for the results of such lab-based progesterone tests, in addition to multiplying anxiety, prevent accurate tracking because the time that it takes to deliver results presents a picture of what occurred in a past part of the menstrual cycle, not a current part of the menstrual cycle. Thus, the use of progesterone testing that requires multiple days for results does not allow for accurate mapping of the cycle until such time that the information loses its value. It would therefore be desirable to have a method that incorporates immediate progesterone testing and tracking to effectively chart a menstrual cycle, determine at which point the subject is in the menstrual cycle, immediately utilize the results and begin the appropriate corrective protocols as necessary.

The Corpus Luteum is supported and maintained by lutenizing hormone (LH) initially, and then the pregnancy hormone human chorionic gonadotrophin (HCG). The corpus luteum begins to decrease in size at around 7-9 weeks of pregnancy. When fertilization or implantation do not occur, the Corpus Luteum will begin to break down 10-14 days following ovulation. This causes a decline in estrogen and progesterone levels, leading to the start of another menstrual period.

Corpus Luteum problems often result from the insufficient production of progesterone or if progesterone production ends too soon. If progesterone is absent or levels are too low, irregular and heavy menstrual bleeding can occur. Lack of progesterone in the bloodstream can mean the ovary has failed to release an egg at ovulation, as can occur in women with polycystic ovary syndrome.

The evaluation of Corpus Luteum functionality is important in association with diagnosing and preventing fertility-related problems. A drop in progesterone during pregnancy can result in a miscarriage and early labor. However, there are available treatments to address related conditions. For instance, those at risk of giving birth too soon can be given a synthetic form of progesterone to delay the onset of labor. Therefore, it would be desirable to have a method that allows for the instantaneous review of results showing progesterone above or below a threshold level over a period of days incorporating a specifically configured device that allows for the delivery of immediate or near-immediate results on each day to alert a pregnant woman immediately that a miscarriage may be imminent without progesterone supplementation.

Corpus Luteum function can also be evaluated by an accurate measurement of progesterone. As a temporary endocrine gland that the female body produces after ovulation during the second half of the menstrual cycle, the Corpus Luteum secretes progesterone, impacting the blood progesterone level. For a woman who menstruates, her blood progesterone level should be low at the beginning of each menstrual cycle. It should peak several days after she has ovulated properly. Then it should fall back to low levels, unless the woman has become pregnant in which case progesterone will continue to be secreted to prevent uterine contractions that may disturb the growing embryo. Ranges of these levels remain generally consistent among properly ovulating females of a particular population, therefore evaluation of these levels to determine whether the test results correlate with the expected progesterone range of a particular population can be used to either confirm proper Corpus Luteum functioning, among other valuable information. However, such results have been only generally available via a blood test or mail-in kit, which limits the availability of repetitive testing over a period of several subsequent days.

The primary present mechanism for evaluating the production of progesterone in woman's body is via a serum progesterone test, or blood test. During such procedure, a medical professional collects a sample of the patient's blood in their office or sends the patient to another site to have blood drawn. Typically the test is then sent to an external lab for testing, a process that typically requires several days to complete. Serum progesterone levels are typically measured in nanograms per milliliter (ng/mL) in the United States of America. Once results are generated from the laboratory, the laboratory will send them to the patient's medical professional, who will generally relay them back to the patient. Many inconveniences to the patient arise from prior art methods of evaluating progesterone via serum draws on a recurrent basis. For many patients, particularly patients living in rural areas, access to blood labs requires a significant expenditure in time and travel costs. Also, for many patients, a visit to a blood testing facility requires missed work. For all patients, the pain and invasive nature of blood testing represents an area for which inventive improvement is desirable. However, more specifically for serum progesterone testing and any other progesterone test that generally requires more than one day for sample collection and evaluation, collection of results on subsequent days without near-instantaneous results for each sample evaluation is impractical for the purposes of accurate corpus luteum evaluation. The slow nature of receiving such test results makes it impractical for evaluation of corpus luteum function that can usefully be applied by the subject for diagnosis and corrective efforts on a continuous basis. Therefore, it would be desirable to have a method for testing for corpus luteum functionality where results may efficiently be collected on subsequent days to correct the drawbacks of previously utilized technologies by utilizing a technology that allows for aggregation and evaluation of progesterone testing results on a near-instantaneous basis in subsequent days.

A variety of devices and methods exist that incorporate a base unit configured to evaluate urine for the presence or absence of one or more hormones and/or analytes in a bodily fluid. Examples of such devices and methods are further described in International Patent Application PCT/CN2017/095452 filed on Aug. 1, 2017, in International Publication Number WO 2019/023926 A1, and U.S. patent application Ser. No. 16/302,085, filed on Jul. 11, 2019, each of which is hereby incorporated by reference herein in its entirety. While such devices and methods have worked in a variety of contexts, such devices lack the specific configuration necessary to detect the presence or absence of critical hormones and analytes associated with the menstrual cycle. Moreover, such items lack the associated steps necessary to detect and address issues associated with corpus luteum functionality.

More specifically, the prior art lacks the specific configuration to enable a test that evaluates urine for the presence of progesterone or progesterone analytes beyond a threshold and at timeframes relevant to assess corpus luteum functionality. It remains desirable to provide an improved system and method to a user to gain near-instantaneous results for the presence or absence of progesterone or its analytes by evaluation of urine or saliva on a daily basis without visitation to a clinic. Such a specifically configured test for urine has not been available until the recent development of the Proov rapid response urine progesterone test by MFB Fertility, Inc., the present applicant, elements of which are further described in PCT Patent Application PCT/US18/68027 and U.S. patent application Ser. No. 16/381,229, each of which are hereby incorporated by reference in their entirety. What also would be desirable is a saliva test configured to sample saliva and provide near-instantaneous results for the presence of progesterone at or above a level corresponding to proper Corpus Luteum functioning to a user as a non-urinary alternative, without requiring the user to deliver the results to a lab for interpretation.

Moreover, existing methods often require direction by a physician for evaluation. Typically, a woman suffering from infertility would seek guidance from a physician. In many cases however, physicians either choose against treating or are prohibited by insurance companies from providing treatment until the patient can document that she has tried for more than twelve months to conceive. When the physician provides treatment, often the first evaluation involves determining whether there is a blocked tube, sperm deficiency, anatomical structural abnormality, or genetic factors prior to evaluating hormonal problems more generally associated with Corpus Luteum functionality. Each of these issues requires time to evaluate. Due to the biological clock, women often at best suffer anxiety as the diagnostic process progresses, and at worst move from a phase in their lives where they can conceive and maintain pregnancy to a phase where they cannot. Thus, it remains desirable for an alternative method to empower women to more rapidly and independently understand and diagnose potential Corpus Luteum functionality problems without the need for involving a physician.

A variety of other problems result from improper Corpus Luteum functioning. For instance, improper luteal function is linked to mood changes and depression. Improper luteal function has also been linked to weight gain, brittle bones, memory loss, PMS, anxiety, perimenopause, and increased risk of ovarian and breast cancer. It would therefore be desirable to have an efficient method to detect improper Corpus Luteum functioning following or preceding the onset of such maladies to allocate appropriate treatment resources.

BRIEF SUMMARY OF THE INVENTION

The present inventor has developed a method for evaluating a non-serum bodily fluid daily over a period of multiple days for the presence of progesterone or an analyte of progesterone beyond a threshold to detect for suboptimal corpus luteum functioning. The preferred example of the method incorporates a system incorporating a specially configured test device useful in association with evaluating corpus luteum functioning.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE FIGURES

FIG. 1 shows method steps associated with a method to evaluate corpus luteum functionality.

FIG. 2 shows method steps associated with a method to estimate the fertile window in association with corpus luteum functionality.

FIG. 3 depicts an embodiment featuring the use of an application operating on a mobile device featuring a camera.

FIG. 4A depicts an embodiment of the test strip featuring a control line and a test line to detect for the presence or absence of PdG.

FIG. 4B depicts an embodiment of the test strip featuring a control line and a plurality of test lines, one of said test lines configured to detect for the presence or absence of PdG.

FIG. 5A depicts an embodiment of a base unit shown in an intended use in conjunction with a cartridge containing a test strip configured to evaluate a bodily fluid for the presence or absence of at least PdG.

FIG. 5B depicts an alternative embodiment of a base unit shown in an intended use in conjunction with a cartridge containing a test strip configured to evaluate a bodily fluid for the presence or absence of at least PdG.

FIG. 6 depicts and embodiment of a test strip contained within a cartridge in exemplary use in association with a base unit.

FIG. 7 depicts exemplary visual indications displayed on a lateral flow assay configured to detect PdG in an applied fluid at a threshold of 5 μg/ml, following the application of a fluid containing varying concentrations of PdG. As can be seen from the drawing, a positive result above 5 μg/ml is determinable when only one line is visible on the lateral flow assay.

DETAILED DESCRIPTION OF THE INVENTION

The present inventor has developed a method for evaluating a non-serum bodily fluid daily over a period of multiple days for the presence of at least progesterone or an analyte of progesterone beyond a threshold to detect for suboptimal corpus luteum functioning.

The method addresses the drawbacks of previous methods of corpus luteum evaluation. The present inventor has discovered a method addressing at least one specific drawback associated with blood serum testing for progesterone, useful in association with evaluating corpus luteum functionality, specifically that progesterone in the bloodstream is cyclical by nature. The cycle of serum progesterone happens as result the corpus luteum forming a part of the endocrine system. More specifically, the corpus luteum secretes progesterone in waves responding to changes in serum progesterone levels. Therefore, as the present inventor has recognized, a single point serum progesterone test may not accurately present an accurate representation of corpus luteum functionality, as it presents the progesterone level at only a single point of time, rather than reporting a trend of serum progesterone levels.

To address this shortcoming, the present inventor devised a method utilizing newly available single tests configured to evaluate urine for the presence of at least progesterone or an analyte of progesterone (such as PdG), which may comprise one or more test strips 3001 configured to evaluate non-serum bodily fluids, such as those further described in U.S. patent application Ser. No. 16/544,554 filed on Aug. 19, 2019, which is incorporated by reference herein in its entirety. The present inventor recognizes that due to variations in the ability of different populations to metabolize progesterone in urine, the 5 μg/ml threshold is not always the appropriate threshold. Therefore, various embodiments of the test strip 3001 are configured to display a positive or negative result based on pre-defined thresholds of a PdG level of a value selected from values within the range of 3 μg/ml-20 μg/ml. Results, in association with embodiments of the invention, demonstrate high concentrations of PdG by depiction in the testing zone of the test strip 3001 of no visually detectible line; and medium concentrations of PdG by depiction in the testing zone of the test strip 3001 of a faint line; and low or zero concentrations of PdG by depiction in the testing zone of the test strip 3001 of a dark line. In the preferred embodiment, a positive result is indicated by the visual display of one colored line on the test strip 3001, indicating the presence of PdG above the pre-defined threshold within the urine test sample applied to the test strip 3001. In an example depicted in FIG. 7, a positive result of >5 μg/mL is indicated on the positive test strip 999 where the control line is visually perceptible to the naked eye and there is no line visually perceptible in the testing zone of the positive test strip 999. In the preferred embodiment, a negative result is indicated by the visual display of two colored lines on the test strip 3001, indicating the absence of PdG above the pre-defined threshold within the urine test sample applied to the test strip 3001. In an example depicted in FIG. 7, a negative result of <5 μg/mL is indicated where the control line is visually perceptible to the naked eye and there is another visually perceptible line in the testing zone of the test strip 3001. Therefore, in one example of the invention, urine samples with a concentration of <5 μg/ml PdG applied to the test strip 3001 will show two lines, indicating a negative result, and urine samples with a concentration of >5 μg/ml PdG applied to the test strip 3001 will only show one line, indicating a positive result. Therefore, in various embodiments of the invention, the present inventor has recognized that the test strip 3001 in a configuration reproducibly produces a negative test result if the PdG level in tested urine is below approximately 5 μg/ml; and the test strip 3001 in a configuration reproducibly produces a positive test result if the PdG level in tested urine is above approximately 5 μg/ml. The present inventor recognizes that due to variations in the ability of different populations to metabolize progesterone in urine, the 5 μg/ml threshold is not always the appropriate threshold. Therefore, various embodiments of the test strip 3001 are configured to display a positive or negative result based on pre-defined thresholds of a PdG level of a value selected from values within the range of 3 μg/ml-20 μg/ml. The present inventor has also recognized that the novel configuration of such single tests are well suited for utilization with additionally configured base units and processing devices to create additional functionality as described elsewhere herein. In association with the invention, a properly functioning corpus luteum is evidenced by a trend indicating the presence of a progesterone analyte at a threshold selected from a range inclusive of 3-20 μg/ml for at least two days during the period of 7-10 days past ovulation.

In association with the methods described herein, a test strip 3001 configured to evaluate urine for the presence of at least progesterone or an analyte of progesterone (e.g., PdG) optionally is configured such that the first capture region is configured such that, when used with a base unit, a first optical signal (e.g., a fluorescent signal) is capable of being detected at the first capture region. The first optical signal may be a readout for the amount of progesterone analyte (e.g., PdG) in the sample, for example, by detecting the amount of first detection reagent bound to the first capture reagent. In such cases, the first optical signal increases when the amount of first analyte present in the sample is low, and the first optical signal decreases when the amount of first analyte present in the sample is high. The optical signal at the first capture region may be proportional to the amount of first analyte present in the sample. In various aspects, the capture zone further comprises a second capture region configured to produce an optical signal likewise corresponding to the presence or absence of a second analyte. In various aspects of the systems and methods herein, the test strip 3001 is configured for utilization in conjunction with a base unit 4001, optionally configured to evaluate a test strip 3001 contained within a cartridge 4002, together comprising a diagnostic test system.

In one aspect, a diagnostic test system is provided comprising: a housing, comprising: a) a port for receiving an assay device, said assay device comprising two or more capture regions; b) a reader comprising: i) one or more light sources for illuminating said two or more capture regions; ii) one or more light detectors for detecting optical signals from said two or more capture regions; and c) a data analyzer having one or more processors configured to: A) receive said optical signals; and determine an amount of at least a first analyte and a second analyte present in a biological sample based on said optical signals, wherein an optical signal of a first of said two or more capture regions increases with decreasing amounts of said first analyte present in said biological sample, and an optical signal of a second of said two or more capture regions increases with increasing amounts of said second analyte present in said biological sample; wherein in an embodiment at least one of the said first capture region or the said second capture regions is configured to detect PdG present in a biological sample in accord with at least the teachings of U.S. patent application Ser. No. 16/544,554 filed on Aug. 19, 2019, which is incorporated by reference herein in its entirety.

The diagnostic test system may include a housing for containing the components of the system. The housing can be constructed of any suitable material. The housing may be configured to receive an immunoassay device configured to detect for at least the presence or absence of progesterone or a progesterone analyte of the disclosure. For example, the housing may include a port or opening for receiving the immunoassay device configured to detect for at least the presence or absence of progesterone or a progesterone analyte. The system may further include, contained within the housing, a reader device. The reader device may include one or more light sources for illuminating the immunoassay device or a region of the immunoassay device configured to detect for at least the presence or absence of progesterone or a progesterone analyte. In one non-limiting example, the one or more light sources are configured to illuminate the capture zone of an immunoassay device configured to detect for at least the presence or absence of progesterone or a progesterone analyte of the disclosure. The type of light source suitable for use with the immunoassay devices will depend on the chemistry of the immunoassay device. In one particular example, the one or more light sources are used to illuminate a detectable label provided by the immunoassay device configured to detect for at least the presence or absence of progesterone or a progesterone analyte. In a particular example, the detectable label provided on the immunoassay device is a fluorophore, and therefore, the one or more light sources of the reader device should include a fluorescent light source (e.g., a light-emitting diode (LED)). It is to be understood that the wavelength of light provided by the light source of the reader device should be selected based on the excitation wavelength of the detectable label, and can readily be selected by a person of skill in the art.

The reader may be configured to illuminate the capture zone and/or the control zone of an immunoassay device configured to detect for at least the presence or absence of progesterone or a progesterone analyte (e.g. PdG) of the disclosure. For example, the reader may be configured to illuminate the first capture region configured to signal the presence or absence of progesterone or a progesterone analyte (e.g. PdG), the second capture region, the first control region, the second control region, or any combination thereof. In some cases, the reader is configured to scan across the test strip of an immunoassay device. In such cases where the immunoassay device utilizes a single fluorophore, the reader may contain a single fluorescent light source. In cases where the immunoassay device utilizes more than one fluorophore, the reader may contain more than one fluorescent light source.

The reader may further comprise one or more light detectors (e.g., a photodetector) for detecting optical signals from the immunoassay device. Generally speaking, the one or more light detectors should be capable of distinguishing between emitted light at a first discrete position and a second discrete position on the immunoassay device. This may be accomplished by, e.g., the one or more light sources scanning across the test strip of the immunoassay device and determining the position of the emitted light on the immunoassay device.

The diagnostic test device may further comprise a data analyzer. The data analyzer may have one or more processors configured to receive an optical signal. In some cases, the data analyzer is in operable communication with a reader device. The data analyzer may be configured to determine an amount of analytes present in a sample, for example, by measuring an amount of optical signal produced at the capture zone of an immunoassay device configured to detect for at least the presence or absence of progesterone or a progesterone analyte. For example, the data analyzer may be configured to calculate the area under the curve of a signal intensity plot. The data analyzer may further be configured to determine the differences between signal intensities among the multiple discrete regions on the test strip. For example, the data analyzer may be configured to determine the difference between the signal intensity at the first capture region and the signal intensity at the second control region. The data analyzer may further be configured to determine the difference between the signal intensity at the second capture region and the signal intensity at the first control region. The data analyzer may further be configured to calculate an amount or concentration of the analytes present in the sample, in one aspect at least one of the analytes present being an analyte of progesterone (e.g. PdG). The data analyzer may be further configured to detect a binary optical pattern. The binary optical pattern can be generated by two fluorescent materials which excitation and/or emission spectrum differs in wavelength. In some cases, the binary optical pattern can be generated by one fluorescent material and one light absorbent material. The detection reagents may be conjugated with the two types of materials respectively and can be captured in the same capture zone, such that the capture zone may generate two different optical signal patterns in the data analyzer.

In various aspects, the system may comprise a housing for containing the electronic components of the system such as that shown in FIGS. 5A, 5B, and 6. The system may have a top housing and a bottom housing. The top housing may comprise a display module for displaying the results of an immunoassay configured to detect for at least the presence or absence of progesterone or a progesterone analyte as described herein. The system may further comprise a display cover. The system may further comprise a battery. The system may further comprise an optomechanics module. The optomechanics module may comprise the one or more light sources and one or more light detectors as described above. The system may further comprise a circuit board containing electronic components. The cassette or housing of the immunoassay test device configured to detect for at least the presence or absence of progesterone or a progesterone analyte may include a cavity. The chamber or receiving port of the diagnostic test system may include a ball bearing contained within the inner wall of the chamber. The ball bearing may hook or latch into the cavity of the test device, thereby locking the immunoassay test device configured to detect for at least the presence or absence of progesterone or a progesterone analyte into the receiving chamber of the diagnostic test system.

The diagnostic test system may include an optomechanics module comprising the one or more light sources for illuminating the test strip of the immunoassay device configured to detect for at least the presence or absence of progesterone or a progesterone analyte. The optomechanics module may be movable across an optical axis such that the optomechanics module moves laterally across the test strip of the immunoassay device configured to detect for at least the presence or absence of progesterone or a progesterone analyte, thereby scanning the test strip. The diagnostic test system may further comprise an actuation module. The actuation module may comprise one or more motors configured to actuate/move the optomechanics module. In some embodiments, the motors may be coupled to a rack and pinion mechanism that is configured to translate the optomechanics module along one or more directions. For example, the optomechanics module can be translated along a longitudinal axis of the test strip of the immunoassay device configured to detect for at least the presence or absence of progesterone or a progesterone analyte. The direction(s) of translation may or may not be orthogonal to an optical axis of the optomechanics module. The direction(s) of translation may be parallel to the longitudinal axis of the test strip, and the optical axis may be orthogonal to the longitudinal axis or a planar surface of the test strip. In some cases, the direction(s) of translation need not be parallel to the longitudinal axis of the test strip, and the optical axis need not be orthogonal to the longitudinal axis (or a planar surface) of the test strip. For example, the direction(s) of translation and/or the optical axis may be at an oblique angle relative to the longitudinal axis of the test strip.

In various aspects, the diagnostic test system may include an optical configuration suitable for use with the diagnostic test system and positioning of the optics above a test strip of an immunoassay device configured to detect for at least the presence or absence of progesterone or a progesterone analyte. The optical configuration may include a light source (e.g., a light-emitting diode (LED) for illuminating the test strip. The optical configuration may further include one or more lens, a filter, optical beamsplitters, or any combination thereof. The optical configuration may further include a photodetector for detecting an optical signal from the immunoassay device configured to detect for at least the presence of progesterone or a progesterone analyte. In an example, the system is configured to an excitation/emission spectra with an excitation wavelength of 492 nm and an emission wavelength of 512 nm.

In some cases, the diagnostic test device generates measurement results (e.g., concentration or relative amounts of analytes present in the sample) from a completed assay performed on the test device, as described throughout. In some cases, the diagnostic test device displays the measurement results on a screen contained within the device. Data containing the measurement results can be transmitted from the diagnostic test device to a mobile device and/or to a server. The data may be transmitted via one or more wireless or wired communication channels. The wireless communication channels may comprise Bluetooth®, WiFi, 3G, and/or 4G networks. The data containing the measurement results may be stored in a memory on the diagnostic test device when the diagnostic test device is not in operable communication with the mobile device and/or the server. The data may be transmitted from the diagnostic test device to the mobile device and/or the server when operable communication between the diagnostic test device and the mobile device and/or the server is re-established.

Further provided herein are kits, in one aspect for inclusion within the context of a method for evaluating corpus luteum functionality, which may include any number of immunoassay test devices configured to detect for at least the presence of progesterone or a progesterone analyte and/or reader devices of the disclosure. In one aspect, a kit is provided for determining qualitatively or quantitatively the presence of progesterone or a progesterone analyte and a second analyte in a biological sample, the kit comprising: a) an assay device configured to detect for at least the presence of progesterone or a progesterone analyte according to an embodiment of the disclosure; and b) instructions for using the kit.

In some cases, kits may include a one or more immunoassay test devices configured to detect for at least the presence of progesterone or a progesterone analyte of the disclosure. In some cases, the kit may provide a plurality of immunoassay devices configured to detect for at least the presence of progesterone or a progesterone analyte to enable a user to conduct a test on more than one occasion. In some cases, the immunoassay devices are configured for a single use (i.e., are disposable). A kit may include a plurality of test devices to enable a user to perform a test once a day, once every 2 days, once every 3 days, once every 4 days, once every 5 days, once every 6 days, once every week, once every 2 weeks, once every 3 weeks, once every 4 weeks, once every 5 weeks, once every 6 weeks once every 7 weeks, once every 8 weeks or more.

In some cases, kits may include a plurality of immunoassay devices, each capable of detecting at least the presence of progesterone or a progesterone analyte along with another analyte of the same type. In other cases, kits may include a plurality of immunoassay devices, each capable of detecting at least the presence of progesterone or a progesterone analyte and other different analytes. In a particular embodiment, a kit may include a plurality of immunoassay devices, each of the immunoassay devices capable of detecting the presence of progesterone or a progesterone analyte and LH in a biological sample. In another particular embodiment, a kit may include a plurality of immunoassay devices, each of the immunoassay devices capable of detecting the presence of progesterone or a progesterone analyte and hCG in a biological sample. In another particular embodiment, a kit may include a plurality of immunoassay devices, each of the immunoassay devices capable of detecting the presence of progesterone or a progesterone analyte and E2 in a biological sample. In another particular embodiment, a kit may include a plurality of immunoassay devices, each of the immunoassay devices capable of detecting the presence of progesterone or a progesterone analyte and FSH in a biological sample. In an embodiment, the immunoassay device may include progesterone or a progesterone analyte in addition to two or more of the additional hormones mentioned in this paragraph. Each of these configurations of immunoassay devices are described further in the present applicant's previous filings, including U.S. patent application Ser. No. 15/974,229, filed on May 8, 2018 claiming priority to U.S. Provisional Patent Application 62/503,223 Filed on May 8, 2017, a claim of priority made to each of which herein, and each of which are incorporated by reference in their entirety herein. These immunoassay devices are further described in U.S. patent application Ser. No. 16/381,229 filed Apr. 11, 2019, which is a national stage application of PCT Application No. PCT/US18/68027, filed Dec. 28, 2018, which is a PCT application claiming priority to U.S. Provisional Application No. 62/611,467 filed Dec. 28, 2017.

More specifically, the present inventor has recognized that due to the many drawbacks associated with serum testing for progesterone levels at one point in time as is commonly practiced, what is instead necessary to more effectively evaluate corpus luteum functionality involves a series of single tests to track progesterone levels (optionally, by evaluating analytes of progesterone in urine that correlate to serum progesterone levels) daily over a period of multiple days. In association with the invention, a positive result for the presence of a progesterone analyte in urine for at least two days during the period of 7-10 days past ovulation corresponds to a healthy corpus luteum. To efficiently facilitate such testing, the method utilizes a number of single tests each configured to evaluate non-serum bodily fluids for the presence of at least progesterone or metabolites of progesterone above a pre-defined threshold level.

The non-serum bodily fluid evaluated via the preferred embodiment of the present invention is urine. To effectively facilitate the method when the non-serum bodily fluid tested is urine, the present inventor has discovered that the best time to collect a sample is immediately after the woman whose corpus luteum is under evaluation wakes up from the longest sleep period of the preceding twenty four hours. The present inventor has noted that this sample consisting of the first morning urine presents a more accurate representation of the previous day's serum progesterone levels.

The present inventor has devised a method for determining functionality of the corpus luteum utilizing specialized testing devices, optionally single tests, depicted in FIG. 1. In various embodiments, the specialized testing devices evaluate non-serum bodily fluids for at least the presence of progesterone or at least one analyte of progesterone. In various embodiments, the testing devices are configured to detect for the presence of Pregnandiol Gluclorinide (PdG) in urine. In the preferred embodiment, the single tests comprise one or more test strips 3001 as further described in U.S. patent application Ser. No. 16/544,554 filed on Aug. 19, 2019, already incorporated by reference herein. In alternative embodiments, the single tests comprise devices to detect for the presence of progesterone in saliva, which optionally may consist of the testing devices described in United States Patent Application Publication US20180106799A1, which is incorporated by reference herein in its entirety. The present inventor has recognized that the methods contemplated herein, in an example, may be utilized in conjunction with a base unit configured read a single test configured to detect for the presence of progesterone in saliva. Optionally, such saliva-based test is configured to detect the presence of progesterone in saliva above or below a threshold set at a value selected from the range of 90-300 pg-ml, which the present inventor recognizes corresponds to a level corresponding to proper Corpus Luteum functioning in a wide range of women.

The inventive method in its preferred form incorporates the step of predicting a date to optimally conduct testing 1001. In an example, the ovulation date is first estimated. During this step, the ovulation date is estimated by sampling cervical mucus, retrieving a basal body temperature, or utilizing lateral flow assays configured to detect for the presence of lutenizing hormone (LH) to predict ovulation. Optionally, the lateral flow assay may be configured as a test strip able to evaluate urine for the presence or absence of PdG on within multiple testing zones on the same strip. In an example, the estimated ovulation date is utilized to calculate the optimal date or range of dates to perform a test to evaluate a bodily fluid for the presence or absence of any of progesterone, PdG, LH, HcG or Estrogen. Optionally, the ovulation date is utilized to calculate the optimal date or range of dates to conduct bodily fluid testing.

Then, following the predicting an ovulation date step, the method preferably includes a collecting step 1002. During the collecting step 1002, a non-serum bodily fluid sample daily is collected for at least three consecutive days. In the case where the non-serum bodily fluid collected is urine, the sample may be collected within a cup during urination. In some instances, where the testing device is configured to allow the urine sample to be collected mid-stream during urination, the urine sample may be collected directly onto the testing device. In the preferred method where the non-serum bodily fluid collected is urine, the urine consists of a urine sample taken in the morning during the first urination after the subject awakens from overnight sleep or the longest sleep of the day (referred to as “first morning urine”). Alternatively, in the case where the non-serum bodily fluid sample collected is saliva, the sample may be collected with a swab. The collection step during the preferred method takes place between 7-10 days past the predicted ovulation date. In any case, the objective of the step is to collect enough of a sample to allow for the non-serum bodily fluid to be temporarily held as needed, and then evaluated by a testing device.

Then, following the collecting step 1002, a testing step 1003 takes place. During the testing step, for each non-serum bodily fluid sample, a testing device is used to evaluate the non-serum bodily fluid sample for the presence of progesterone or a metabolite of progesterone. In the preferred method, the testing step 1003 utilizes a single test consisting of a single-use disposable non-serum bodily fluid test configured to detect for at least progesterone or a metabolite of progesterone above a pre-defined threshold. In an embodiment of the invention, the non-serum bodily fluid test is configured to evaluate urine for the presence of at least one metabolite of progesterone, optionally PdG, above a threshold of 5 ug/mL. In an embodiment, the pre-defined threshold is determined from a value chosen from a sliding scale. In an embodiment, a threshold from within the scale's range is a value within the range of 3-10 ug/ml. During the testing step 1003, the single test indicates whether progesterone or a metabolite of progesterone is present in the tested non-serum bodily fluid sample above a pre-defined threshold. Optionally, the threshold amount may be set to the minimum amount of progesterone or progesterone analyte corresponding to the amount of minimum amount of progesterone needed to be present in the bloodstream to indicate that ovulation has occurred. A result indicated by the single test of “positive” means that the level of progesterone or analyte of progesterone present in the tested non-serum bodily fluid sample has exceeded the pre-defined threshold. A result indicated by the single test of “negative” means that the level of progesterone or analyte of progesterone present in the tested non-serum bodily fluid sample has not exceeded the pre-defined threshold. In an related example, a result indicated by the single test of “positive” could further indicate that the woman has entered into her infertile phase, and may thereby engage in sexual intercourse without the risk of unintended conception.

Then, following the first positive result indicated by the single test, indicating the presence of progesterone or a metabolite of progesterone above a pre-defined threshold in the tested non-serum bodily fluid sample, or the first fold change, a repeating step 1004 takes place. During the preferred method, the repeating step 1004, the collecting step 1002 and the testing step 1003 are performed over and over on a daily basis until the first negative result for progesterone or PdG displayed on the single test, indicating that progesterone or a metabolite of progesterone is below the pre-defined threshold. Alternatively the repeating step 1004 takes place daily for only 3 consecutive days, or for 4-10 days, regardless of the results displayed on the testing device. In the event that a positive result for the presence of progesterone or a metabolite of progesterone occurs at least two times during the repeating step, a properly functioning corpus luteum is indicated. The present inventor has recognized that performing the repeating step 1004 multiple times during a fixed period of time, ideally a timeframe chosen from the range of 3-10 days, occasionally has the effect of mitigating errors displayed on the single test.

Following the conclusion of the repeating step 1004 or multiple repeating steps 1004, where one or more additional iterations of the collecting step 1002 and the testing step 1003 have taken place, a recording step 1005 takes place. During the recording step 1005, the total number of days that the single test has indicated a positive result for progesterone or PdG, each positive result indicating the presence of progesterone or a metabolite of progesterone above the pre-defined threshold at the time of testing, prior to the first negative result for progesterone or PdG displayed on the single test, is recorded. In the example where at least two positive results have been indicated during the timeframe of 7-10 days past ovulation, a properly functioning corpus luteum is indicated. Such recordation may optionally take place with the assistance of a calendar or similar application operating on a mobile device. Such application may optionally also allow its user to record results for testing devices that evaluate bodily fluids for Lutenizing Hormone (LH), Follicle Stimulating Hormone (FSH), and/or Estrogen or Estrogen metabolites.

The present inventor has noted that a mobile device operating an application featuring the ability to facilitate the recording step 1005 described above. In an example of the invention, an application operating on a mobile device featuring a camera, as depicted in FIG. 3, may be configured and utilized to photograph the results of a single test, and near-simultaneously interpret and record the results of each single test. The present inventor has noted that this example of the method is particularly helpful in instances where a single test incorporates one or more test strips 3001 configured to evaluate for multiple hormones and/or analytes, as is further described in U.S. patent application Ser. No. 16/381,229, filed on Apr. 11, 2019, incorporated by reference herein in its entirety. In one embodiment, the test strip used in accordance with the method described herein is configured to evaluate urine for the presence of PdG and LH.

Corpus luteum functionality and fertility and the fertile window within the menstrual cycle are closely related. In a related method, depicted in FIG. 2, following the step of collecting a single sample of urine 2001 optionally consisting of a woman urinating into a cup, a testing step 2002 follows. During an exemplary testing step, a single test configured to evaluate urine is placed into contact with the previously collected single sample of urine and utilized to detect for whether both PdG and LH are present in the single sample of urine, each above a pre-defined threshold. Following the testing step, a step of determining whether ovulation has occurred 2003 follows. During an exemplary determining whether ovulation has occurred step, an indication on a single test that PdG exceeds a predefined threshold, optionally 5ug/mL, signals that ovulation has occurred. In an example, the indication by the test strip 3001 that ovulation has occurred is presented by a visual label. In an example, the visual label is perceptible by the human eye. In an alternative example, the visual label consists of fluorescent dye imperceptible to the human eye readable only with the assistance of a machine, optionally a base unit 4001 or digital reader 3002. Following the determining whether ovulation has occurred step, a step of estimating the fertile window 2004 occurs. During an example of such step, the fertile window is estimated by calculating a number of days, optionally two days, following the first positive indication of LH after a negative indication for LH from the immediately preceding day's testing. For practical purposes, a urinary LH concentration of 20 ml U/ml can be regarded as a universal threshold indicative of the LH Surge under virtually all circumstances. Once the LH surge has been detected, it can be said that ovulation is imminent. An alternative method to self-confirm ovulation without hormone evaluation is through the tracking of basal body temperature (BBT). In association with such method, a female's temperature is tracked shortly after awaking in the morning on a daily basis. When the temperature significantly rises, by 0.5-1 degree Fahrenheit or more, ovulation is indicated. The estimating the fertile window step also optionally comprises confirming a negative indication for PdG in urine, as a positive indication would signify that the fertile window has closed as the presence of PdG correlates to prior ovulation. A method for predicting the end of the fertile period is to measure the levels of the urinary hormone PdG. PdG has a relatively low level in urine until the start of the luteal phase, at which point its level rises fairly sharply. Therefore, once an elevated level of PdG is detected, it can be indicated to the user that the luteal phase of the cycle—i.e. the terminal infertile period-has commenced.

To further illustrate, in a series of tests associated with the methods described herein, if the following occurs, ovulation may be confirmed over a three tests on three separate days to aid in the estimation of the functionality of the corpus luteum and a prediction of the fertile window:

-   -   Example 1—test one results in readings of PdG below a         pre-defined threshold and LH below a pre-defined threshold; test         two results in PdG above a pre-defined threshold and LH above a         pre-defined threshold; test three results in PdG above a         pre-defined threshold and LH below a pre-defined threshold. This         Example 1 signifies that following an LH surge indicating the         follicle maturation, that progesterone released indicating         ovulation. Such a result demonstrates proper corpus luteum         functioning.     -   Example 2—test one, results in readings of PdG below a         pre-defined threshold and LH below a pre-defined threshold; test         two results in readings of PdG below a pre-defined threshold and         LH a pre-defined threshold; test three results in readings of         PdG a pre-defined threshold and LH above a pre-defined         threshold. This Example 2 signifies that following a sustained         LH surge indicating follicle maturation, that progesterone         released indicating ovulation. Such a result demonstrates proper         corpus luteum functioning.     -   Example 3—test one results in PdG below a pre-defined threshold         and LH below a pre-defined threshold; test two results in PdG         above a pre-defined threshold and LH below a pre-defined         threshold. This Example 3 signifies that either the LH surge was         missed by the test results or that urine was too diluted to         detect the LH surge, but regardless that progesterone was         released indicating ovulation. Such a result demonstrates proper         corpus luteum functioning. Such result also highlights the         importance of multiple day testing utilizing disposable test         strips 3001 in accordance with the methods described herein as         opposed to single point testing.

To further illustrate, in a series of tests, if the following occurs, a potential problem with the functionality of the corpus luteum may be detected:

-   -   Example 4—test one, results in readings of PdG below a         pre-defined threshold and LH below a pre-defined threshold; test         two results in readings of PdG below a pre-defined threshold and         LH above a pre-defined threshold; test three results in readings         of PdG below a pre-defined threshold and LH below a pre-defined         threshold. Such a result indicates the possibility of improper         corpus luteum functioning. As no progesterone (or its analyte,         PdG) was detected during this exemplary series, it is possible         that the relevant corpus luteum is not functioning properly to         support implantation.

In embodiments of the invention, the tests utilized (optionally a “single test” which as used herein comprises one or more test strips 3001 that are disposable and altogether intended to be utilized one time to evaluate a single non-serum bodily fluid sample) incorporate a pre-defined threshold of PdG correlating in a positive result to at least the lowest amount of progesterone present and necessary to support conception. In embodiments of the invention, the tests utilized (optionally a single test) incorporate a pre-defined threshold of LH correlating in a positive result to at least the lowest amount of LH necessary to fully mature a follicle and cause rupture). In an embodiment of the invention, the pre-defined threshold of PdG is determined by a fixed amount of PdG antibody on the conjugate pad and the amount of PdG conjugate impregnated on the membrane in competitive assay form. In an embodiment of the invention, the pre-defined threshold of LH is determined by a fixed amount of LH antibody on the conjugate pad and the amount of LH antibody on the membrane in sandwich assay form. In an embodiment of the invention, the sandwich assay form and the competitive assay form are integrated together into a single test. In an embodiment of the invention, the receiving zones containing the LH antibody and the PdG antibody, and optionally antibodies of other hormones or analytes including FSH, Estrogen analyte, and hCG, are incorporated into a single conjugate pad within a single test. In an alternative embodiment of the invention, the receiving zones containing the LH antibody and the PdG antibody, and optionally antibodies of other hormones or analytes including FSH, Estrogen analyte, and hCG, are incorporated into at least two discrete conjugate pads within a single test. In an embodiment of the invention, the test strip 3001 is configured to incorporate multiple visual labels, including a test line 3003 and a visual label indicating the absence or presence of PdG 3006, a visual label indicating the absence or presence of LH, 3007, and a visual label indicating the absence or presence of estrogen or an analyte of estrogen 3008, as depicted in FIG. 4B. In an embodiment of the invention, the pre-defined threshold of PdG and/or the pre-defined threshold of LH is determined by a percentage difference from a previous test, optionally indicating a trend or fold change. In an embodiment, the test is contained within a cartridge. Optionally, the test or cartridge surrounding the test further incorporates an identifying feature, such as a QR Code, bar code or lot number, to identify the specific test and/or corresponding results. An example of such a single test incorporating such an identifying feature is further described in United States Patent Application Publication US 2018/0196037 A1 published on Jul. 12, 2018, which is hereby incorporated by reference in its entirety. In an embodiment, each conjugate pad may comprise antibodies conjugated to the same visual dye or different visual dyes.

For example, in some cases, the detecting of the presence or absence of hormones and/or analytes comprises: (A) illuminating the first capture region (as used herein, the term “capture region” is also referred to as “testing zone”) and the second capture region with one or more light sources; (B) detecting the first optical signal from the first capture region and the second optical signal from the second capture region with one or more optical detectors; (C) determining an amount of the first analyte or hormone present in the biological sample based on a level of the first optical signal; and (D) determining an amount of the second analyte present in the biological sample based on a level of the second optical signal. In some cases, the first capture region is downstream of the second capture region on the test strip. In some cases, the second capture region is downstream of the first capture region on the test strip. In some cases, the first fluorescent label and the second fluorescent label are the same. In another aspect, an assay device is provided for determining a presence of at least a first analyte and a second analyte in a biological sample, the assay device comprising: a test strip defining a flow path and comprising: a) at a first end, a sample zone configured to be contacted with a biological sample suspected of containing the first analyte and the second analyte; b) a labeling zone having absorbed thereon a mobilizable first detection reagent conjugated to a first fluorescent label and a mobilizable second detection reagent conjugated to a second fluorescent label, which the first detection reagent specifically binds to the first analyte thereby forming a first analyte-first detection reagent complex and the second detection reagent specifically binds to the second analyte thereby forming a second analyte-second detection reagent complex; c) a capture zone comprising a first capture region and a second capture region, wherein the first capture region has immobilized thereon a first capture reagent which specifically binds to the first detection reagent when the first detection reagent is not in a complex with the first analyte, and the second capture region has immobilized thereon a second capture reagent which specifically binds to the second analyte-second detection reagent complex, wherein a first optical signal from the first fluorescent label is capable of being detected at the first capture region and which the first optical signal decreases with increasing amounts of the first analyte present in the biological sample, and wherein a second optical signal from the second fluorescent label is capable of being detected at the second capture region and which the second optical signal increases with increasing amounts of the second analyte present in the biological sample. In some cases, the first capture region is downstream of the second capture region on the test strip. In some cases, the second capture region is downstream of the first capture region on the test strip. In some cases, the assay device further comprises, downstream of the capture zone, a control zone comprising a first control region having immobilized thereon a first control reagent which binds to the first detection reagent and the second detection reagent, and a second control region having immobilized thereon a second control reagent which binds to the first detection reagent and the second detection reagent. In some cases, the assay device is configured to be inserted into a reader device for detecting the first and second optical signals from the first and second fluorescent labels. In some cases, the assay device further comprises a readable, or readable and writable chip, configured to be read and wrote by the reader device. In some cases, the readable chip comprises information related to the biological sample, the assay device, or both. In some cases, the first capture reagent does not displace the first analyte from the first detection reagent if the first analyte is bound to the first detection reagent. In some cases, the first capture reagent does not bind to the first analyte-first detection reagent complex. In some cases, the second capture reagent does not bind to non-complexed second analyte or non-complexed second detection reagent. In some cases, the first fluorescent label and the second fluorescent label are the same. In some cases, the first fluorescent label and the second fluorescent label are different. In some cases, the first detection reagent, the second detection reagent, or both is an antibody or antibody fragment. In some cases, the first detection reagent, the second detection reagent, or both is an antigen. In some cases, the biological sample is blood, urine, or saliva. In some cases, the first analyte is estrone-3-glucuronide (E3G) and the second analyte is luteinizing hormone (LH). In some cases, the first detection reagent is an anti-E3G antibody and the second detection reagent is an anti-LH antibody. In some cases, the first capture reagent is a protein-E3G antigen complex and the second capture reagent is an anti-LH antibody. In some cases, a decrease in the first optical signal and an increase in the second optical signal are indicative of a time of an elevated ovulation cycle of a mammal. In some cases, the first control reagent and the second control reagent are anti-mouse IgG antibody. In another aspect, a diagnostic test system is provided, comprising: a housing, comprising: a) a port for receiving an assay device, the assay device comprising two or more capture regions; b) a reader comprising: i) one or more light sources for illuminating the two or more capture regions; ii) one or more light detectors for detecting optical signals from the two or more capture regions; and c) a data analyzer having one or more processors configured to: A) receive the optical signals; and B) determine an amount of at least a first analyte and a second analyte present in a biological sample based on the optical signals, wherein an optical signal of a first of the two or more capture regions increases with decreasing amounts of the first analyte present in the biological sample, and an optical signal of a second of the two or more capture regions increases with increasing amounts of the second analyte present in the biological sample. In some cases, the diagnostic test system is further configured to detect optical signals from two or more control regions on the assay device. In some cases, the diagnostic test system is further configured to compare optical signals from the two or more control regions with optical signals from the two or more capture regions. In some cases, the assay device comprises any assay device described above. In some cases, the assay device further comprises a second end, configured to be inserted into the port of the diagnostic test system. In some cases, the data analyzer is configured to detect an optical pattern of the optical signals. In some cases, the optical pattern is a binary optical pattern. In some cases, the assay device further comprises a readable chip configured to be detected by the reader. In some cases, the readable chip comprises information related to the biological sample, the assay device, or both. In some cases, the reader is configured to transmit a data output to a mobile device. In some cases, the data output comprises a medical result based on the amount of first analyte and the amount of second analyte present in the biological sample. In some cases, the optical signals are fluorescent signals. The device may be used to test for the presence or absence of at least a first analyte and a second analyte in a sample. In some cases, the device may be used to determine an amount or a relative amount of at least a first and second analyte in a sample. Other features of the immunoassay device may include a test strip cassette for supporting and/or protecting the test strip. The cassette may be composed of a sturdy material such as plastic (e.g., high-impact polystyrene). The cassette may include, at a proximal end, a sample application window for applying a fluid sample to the sample pad. The cassette may further include an assay results window for visualization of the assay results. The assay results window may be positioned on the device directly above the capture zone and control zone such that a detectable signal can be visualized or read (e.g., by a diagnostic test system). The cassette may be of a certain size and shape so as to be compatible with a diagnostic test device of the disclosure, such that the cassette may be inserted into a cavity, port or receiver of a diagnostic test device. In one aspect, a diagnostic test system is provided comprising: a housing, comprising: a) a port for receiving an assay device, said assay device comprising two or more capture regions; b) a reader comprising: i) one or more light sources for illuminating said two or more capture regions; ii) one or more light detectors for detecting optical signals from said two or more capture regions; and c) a data analyzer having one or more processors configured to: A) receive said optical signals; and B) determine an amount of at least a first analyte and a second analyte present in a biological sample based on said optical signals, wherein an optical signal of a first of said two or more capture regions increases with decreasing amounts of said first analyte present in said biological sample, and an optical signal of a second of said two or more capture regions increases with increasing amounts of said second analyte present in said biological sample. The diagnostic test system may include a housing for containing the components of the system. The housing can be constructed of any suitable material. The housing may be configured to receive an immunoassay device of the disclosure. For example, the housing may include a port or opening for receiving the immunoassay device. The cassette or housing of the immunoassay test device may include a cavity. The cavity, opening or port of the diagnostic test system may include a ball bearing contained within the inner wall of the chamber. The ball bearing may hook or latch into the cavity of the test device, thereby locking the immunoassay test device into the receiving chamber of the diagnostic test system. The system may further include, contained within the housing, a reader device. The reader device may include one or more light sources for illuminating the immunoassay device or a region of the immunoassay device. In one non-limiting example, the one or more light sources are configured to illuminate the capture zone of an immunoassay device of the disclosure. The type of light source suitable for use with the immunoassay devices will depend on the chemistry of the immunoassay device. In one particular example, the one or more light sources are used to illuminate a detectable label provided by the immunoassay device. In a particular example, the detectable label provided on the immunoassay device is a fluorophore, and therefore, the one or more light sources of the reader device should include a fluorescent light source (e.g., a light-emitting diode (LED)). It is to be understood that the wavelength of light provided by the light source of the reader device should be selected based on the excitation wavelength of the detectable label, and can readily be selected by a person of skill in the art. The reader may be configured to illuminate the capture zone and/or the control zone of an immunoassay device of the disclosure. For example, the reader may be configured to illuminate the first capture region, the second capture region, the first control region, the second control region, or any combination thereof. In some cases, the reader is configured to scan across the test strip of an immunoassay device. In such cases where the immunoassay device utilizes a single fluorophore, the reader may contain a single fluorescent light source. In cases where the immunoassay device utilizes more than one fluorophore, the reader may contain more than one fluorescent light source. The reader may further comprise one or more light detectors (e.g., a photodetector) for detecting optical signals from the immunoassay device. Generally speaking, the one or more light detectors should be capable of distinguishing between emitted light at a first discrete position and a second discrete position on the immunoassay device. This may be accomplished by, e.g., the one or more light sources scanning across the test strip of the immunoassay device and determining the position of the emitted light on the immunoassay device. The diagnostic test device may further comprise a data analyzer. The data analyzer may have one or more processors configured to receive an optical signal. In some cases, the data analyzer is in operable communication with a reader device. The data analyzer may be configured to determine an amount of analytes present in a sample, for example, by measuring an amount of optical signal produced at the capture zone of an immunoassay device. For example, the data analyzer may be configured to calculate the area under the curve of a signal intensity plot. The data analyzer may further be configured to determine the differences between signal intensities among the multiple discrete regions on the test strip. For example, the data analyzer may be configured to determine the difference between the signal intensity at the first capture region and the signal intensity at the second control region. The data analyzer may further be configured to determine the difference between the signal intensity at the second capture region and the signal intensity at the first control region. The data analyzer may further be configured to calculate an amount or concentration of the analytes present in the sample. The data analyzer may be further configured to detect a binary optical pattern. The binary optical pattern can be generated by two fluorescent materials which excitation and/or emission spectrum differs in wavelength. In some cases, the binary optical pattern can be generated by one fluorescent material and one light absorbent material. The detection reagents may be conjugated with the two types of materials respectively and can be captured in the same capture zone, such that the capture zone may generate two different optical signal patterns in the data analyzer. In some cases, the diagnostic test device, optionally in association with the data analyzer, generates measurement results (e.g., concentration or relative amounts of analytes present in the sample) from a completed assay performed on the test device, as described throughout. In some cases, the diagnostic test device displays the measurement results on the device screen. Data containing the measurement results can be transmitted from the diagnostic test device to a mobile device and/or to a server. The data may be transmitted via one or more wireless or wired communication channels. The wireless communication channels may comprise Bluetooth®, WiFi, 3G, and/or 4G networks.

In association with the above described method and other methods of use, a suitably configured single test able to detect for the presence of at least PdG or Progesterone in a bodily fluid is useful. Such a single test optionally comprises one or more test strips 3001 described with particularity in U.S. Patent Applications No. 62/720,953, filed on Aug. 22, 2018; Ser. No. 15/974,229 filed May 8, 2018; and Ser. No. 16/381,229 filed Apr. 11, 2019; the entire contents of said applications hereby incorporated by reference. Referring now to FIG. 4, a test strip 3001 of the present invention is shown wherein an end with a sample pad is dipped into a urine sample such that the urine sample flows up the test strip 3001 in a direction depicted by an arrow and is stopped by an adsorbent pad at an end opposite the sample pad. The sample pad is readily available from various supplies, such as SureWick Pad Materials from Millipore Sigma. The test strip 3001 includes a conjugate pad that can be a glass fiber conjugate pad saturated with colloidal gold, colored latex beads or other visual dye particles that are conjugated to anti-pregnanediol gluconoride mouse monoclonal antibodies. A membrane of the test strip 3001 can be a nitrocellulose membrane with pore size between 3 to 20 μm. At least a test line configured to detect for the presence or absence of PdG in the tested fluid 3006 and a control line 3003 are impregnated on the membrane. The membrane is supported by a backing card.

The present inventor has discovered a unique combination of specific elements to allow for the detection of pregnanediol glucuronide (PdG) formulated such as to enable the creation of a pregnanediol urine test. In the preferred embodiment of the invention, Bovine Gamma Globulin (BGG) is conjugated with PdG and combined with a mouse anti-PdG antibody of IgG2b isotype binding partner. In an alternative embodiment of the invention Bovine Gamma Globulin (BGG) conjugated to PdG is combined with a mouse anti-PdG antibody of IgG1, IgG1 Kappa, IgG2a or IgG2c isotype. The present inventor has recognized that such a specific combination uniquely allows for colloidal gold to be conjugated to the anti-PdG antibody of one of the specific isotypes mentioned above, and for the colloidal gold conjugated anti-PdG antibody to interact with the PdG-BGG conjugate. Other combinations have been attempted, and have failed to allow the colloidal gold to function to produce the color needed to allow the test results to be viewable visually by the naked and untrained (layperson) eye. The present inventor has noted that the utilization of BGG conjugated to PdG allows for anti-PdG antibody, specifically of the IgG2b isotype, to bind in such a manner that colloidal gold is carried at a concentration sufficient for naked eye visualization. The present inventor notes that Globulins evidence the preferable binding ratio of 8-32 PdG antigens per Globulin, which favor presentation of a visual result perceptible to the naked eye or to a reader. It is therefore a teaching of embodiments of the invention to comprise a carrier protein demonstrating the binding ration of 8-32 PdG antigens per carrier protein. The present inventor has recognized the benefit associated with embodiments of the invention described herein that a PdG test may be producible allowing the results to be visually interpreted with the naked eye. The present inventor has recognized the benefit associated with embodiments of the invention that a PdG test may be producible allowing the results to be visually interpreted with the naked eye.

The preferred embodiment of the invention relies on the certain reagents being able to interact with other reagents to produce color in the test zone of the membrane. Specifically, in the absence of PdG analyte in the urine sample, the following reagents must interact in order for the test results to be useful. First, in the preferred embodiment, colloidal gold must be conjugated to the anti-PdG antibody (in the preferred embodiment, anti-PdG antibody having the IgG2b isotype). In alternative embodiments, as a replacement for colloidial gold in other embodiments described herein, an alternative visual dye such as latex beads may be utilized to a similar effect. Further, in embodiments of the invention, the colloidal gold conjugated anti-PdG antibody must interact with the PdG-BGG conjugate. Moreover, the PdG-BGG must bind the nitrocellulose membrane. The present inventor has recognized that for these embodiments to function as intended, these interactions between and among the colloidal gold conjugated anti-PdG antibody and the PdG-BGG conjugate must be strong enough and stable enough to form and stay bound during urine sample application and lateral flow of urine across the reaction zone to solve the problems faced by the suboptimal prior art mechanisms. In an embodiment configured to evaluate urine for hormones and/or analytes other than PdG in addition to PdG, a visual label having a distinct color is utilized to identify for the presence of each hormone and/or analyte tested. In one particular embodiment, a colloidal gold conjugated anti-PdG antibody is utilized to display or omits the color red to indicate the absence or presence of PdG within a sample and a latex bead conjugated anti-LH antibody is utilized to display or omit the color blue to indicate the absence or presence of LH within the same urine sample on the same test strip. In an embodiment, a test strip configured to evaluate urine for the presence of PdG and LH is contained within a cassette. In an embodiment, also further described in U.S. patent application Ser. No. 15/974,229, filed on May 8, 2018, incorporated by reference in its entirety herein, a disposable lateral flow assay tests cassette is configured to allow the sample to permeate through the one or more test strips 3001 into or through one or more detection zones, each optionally comprising a reagent-impregnated membrane, contained within each test strip. In an embodiment of the invention, the test strip in its novel configuration as described elsewhere herein is contained within a cartridge (also referred to as a “detection device”), and configured to be read within an associated base unit (also referred to as a “detection instrument”) as further described within U.S. patent application Ser. No. 16/302,085, filed on Jul. 11, 2019, which is hereby incorporated by reference herein in its entirety. In an embodiment of the invention, the base unit consists of an improved version of the diagnostic test system as described in International Patent Application PCT/CN2017/095452 filed on Aug. 1, 2017 and in International Publication Number WO 2019/023926 A1, which are hereby incorporated by reference in its entirety, and the improvements of such diagnostic test system as described elsewhere herein, in one aspect such improvements including the novel methods of utilization.

An embodiment of the present invention comprises a testing system to detect the presence of PdG optimized for visual detection by a layperson's, or non-expert's, naked eye utilizing the embodiment in other than a laboratory context. The present inventor has recognized that in embodiments of the invention, the combination of mouse anti-PdG IgG1, IgG2a, IgG2b, and/or the IgG2c antibody conjugated to a visual label, such as colloidal gold and/or latex beads, and PdG conjugated to BGG carrier protein create sufficient binding partners. Resultantly, the preferred embodiment of the invention comprises a visual test readable by the untrained eye in a context outside of a laboratory environment, as depicted in FIGS. 4A-4B. In an embodiment, the visual label comprises colloidal gold 40 nm particles having an absorbance of 520-540 nm.

In varying embodiments of the invention, the visual label comprises particles having an absorbance of 380-750 nm which the present inventor notes is the approximate range typically perceptible to the human eye. In an alternative embodiment, the visual label comprises a fluorescent dye. In an embodiment, the fluorescent dye is readable only with the assistance of a machine configured to detect wavelengths on the visual spectrum outside of the range perceptible by the human eye. In an embodiment, the visual label comprises colloidal gold 40 nm particles having an absorbance of 520-540 nm.

As noted elsewhere in this application, the visual label in embodiments of the invention comprise particles having an absorbance of 380-750 nm which the present inventor notes is the approximate range typically perceptible to the human eye. In an alternative embodiment, the visual label comprises a fluorescent dye. In an embodiment, the configuration of the test strip and optionally a corresponding base unit are configured to allow for the interpretation of the results of the strip to indicate for the presence or absence of progesterone or analytes of progesterone due to the unique and novel configurations disclosed herein conjugated with a fluorescent label. An example of a lateral flow assay utilizing such a fluorescent dye label is described further in U.S. patent application Ser. No. 11/974,358, filed on Oct. 12, 2007, which is hereby incorporated by reference in its entirety. In an embodiment of the test strip, the visual label comprises particles having an absorbance of 190-380 nm, which the present inventor notes is the ultraviolet region imperceptible to the human eye. In an embodiment, the fluorescent dye is readable only with the assistance of a machine configured to detect wavelengths on the visual spectrum outside of the range perceptible by the human eye, which in an example is further described in U.S. patent application Ser. No. 11/974,358 mentioned above. The test results featuring a visual label imperceptible to the human eye of a test strip 3001 are optionally determinable by ultraviolet visible spectroscopy. In one embodiment, the device configured to interpret the results of a test strip featuring a visual label imperceptible to the human eye consists of a base unit 4001. In an alternative embodiment, the test results are interpreted with the assistance of a digital reader 3002. In an embodiment of the invention, the digital reader 3002 comprises a mobile phone device as depicted in FIG. 3.

The methods disclosed herein comprise one or more steps or actions for achieving the described method. The method steps and/or actions may be interchanged with one another without departing from the scope of the claims. The order and/or use of specific steps and/or actions may be modified without departing from the scope of the claims.

It is to be understood that the claims are not limited to the precise configuration and components illustrated above. Various modifications, changes and variations may be made in the arrangement, operation and details of the methods and apparatus described above without departing from the scope of the disclosure.

While the foregoing is directed to aspects of the present disclosure, other and further aspects of the disclosure may be devised without departing from the basic scope thereof. 

I claim:
 1. A method for evaluating urine of a subject to estimate the fertile window, comprising: collecting a single sample of urine; testing the single sample of urine with a single test comprising a specially configured lateral flow assay, the specially configured lateral flow assay comprising: a sample pad configured to receive the urine sample, a receiving zone within a conjugate pad, the conjugate pad saturated with a conjugate comprising an anti-PdG antibody conjugated to a first visual label in a concentration selected from the range inclusive of 1-10 μg/ml and a conjugate comprising an anti-LH antibody conjugated to a second visual label, a membrane comprising a first testing zone and, a second testing zone, and a control line, the first testing zone comprising PdG conjugated to a carrier protein that binds PdG antigens at 8-32 molecules per carrier protein, and further configured to evaluate for the presence or absence of PdG at or above a PdG threshold, the PdG threshold selected from within the range inclusive of 3-20 μg/ml, the second testing zone comprising LH conjugated to a carrier protein and further configured to evaluate for the presence or absence of LH at a LH threshold of no less than 20 ml U/ml, the membrane further configured to provide an observable positive result for the presence of PdG at the PdG threshold as indicated by the absence of the color of the first visual label in the first testing zone following the operation of the specially configured lateral flow assay, and the membrane further configured to provide an observable positive result for the presence of LH at a LH threshold as indicated by the presence of the color of the second visual label in the second testing zone following the operation of the specially configured lateral flow assay, determining that ovulation has occurred and that the fertile window has closed by a positive result for the presence of PdG at the PdG threshold or determining that the fertile window has opened by observing a positive result for the presence of LH at or above the LH threshold, and estimating the fertile window dates, optionally by repeating the collecting, testing and determining steps, the fertile window opening date estimated as the date of the positive result for the presence of LH at or above the LH threshold and the fertile window closing date estimated as the date of the positive result for the presence of PdG at the PdG threshold.
 2. A method for evaluating a series of samples of a non-serum bodily fluid sample of a subject, each sample of the series collected daily during a period of at least three and not more than four consecutive days during the timeframe of 7-10 days past the ovulation date, to evaluate corpus luteum function by estimating the levels of progesterone, comprising: predicting the timeframe of 7-10 days past the ovulation date to optimally conduct testing for progesterone or a progesterone metabolite by a step selected from the group consisting of: a. testing urine with a lateral flow assay test configured to evaluate urine for the presence of luteinizing hormone to determine the ovulation date; b. measuring a rise in basal body temperature of at least 0.5 degrees Fahrenheit to determine the ovulation date; c. utilizing a menstrual cycle tracking application operating on a mobile device configured to determine the ovulation date; and d. sampling cervical mucus to determine the ovulation date, collecting a non-serum bodily fluid sample daily for at least three and not more than four consecutive days during the timeframe of 7-10 days past the ovulation date; for each fluid sample collected on each of the consecutive days, testing for the presence of progesterone or a metabolite of progesterone by a step selected from the group consisting of: a. evaluating urine with a specially configured lateral flow assay, the specially configured lateral flow assay comprising: a sample pad configured to receive each urine sample, a receiving zone within a conjugate pad, the conjugate pad saturated with a conjugate of an anti-PdG antibody conjugated to a visual label at a concentration of 1-10 μg/ml, and a membrane comprising a testing zone, the testing zone comprising a PdG conjugated to a carrier protein that binds PdG antigens at 8-32 molecules per carrier protein and configured to evaluate for the presence or absence of PdG at or above a PdG threshold, the PdG threshold selected from within the range inclusive of 3-20 μg/ml, and an adsorbent pad at an end of the specially configured lateral flow assay opposite from the sample pad; b. evaluating a saliva sample with the aid of a diagnostic test system, the diagnostic test system comprising: an assay device comprising at least one testing region configured to evaluate an applied saliva sample for the presence of progesterone or a progesterone analyte, a port for receiving an assay device, a reader comprising one or more light sources for illuminating the testing region, a data analyzer configured to receive optical signals and determine an amount of an analyte present in the saliva sample, and transmit a result as an output; and evaluating saliva with a lateral flow test device for quantitatively detecting an analyte in a saliva sample configured to quantitatively detect progesterone at or above a threshold value selected from the range of 90-300 pg/ml; observing the result for the presence of progesterone or a metabolite of progesterone; following the first result indicating the presence of progesterone or a metabolite of progesterone above the PdG threshold in the tested non-serum bodily fluid sample or the first fold change, repeating the collecting step and the testing step for three days or until the first result indicating progesterone or a metabolite of progesterone is below the PdG threshold; and recording the total number of days the presence of progesterone is indicated or a metabolite of progesterone is indicated above the PdG threshold during the timeframe of 7-10 days past the ovulation date, or the total number of days the presence of progesterone is indicated or a metabolite of progesterone is indicated above the PdG threshold prior to the first result indicating progesterone is absent or a metabolite of progesterone is below the PdG threshold.
 3. The method of claim 2, further comprising: determining an elevated risk of suboptimal corpus luteum functionality following less than two consecutive days of test results that signal that the presence of progesterone is indicated or a metabolite of progesterone is present at or above the PdG threshold.
 4. The method of claim 2, the predicting step further comprising predicting an ovulation date; the collecting step first taking place between 7-10 days past the predicted ovulation date.
 5. The method of claim 2, the non-serum bodily fluid sample consisting of first morning urine.
 6. The method of claim 2, the collecting step recurring on three consecutive days.
 7. A method for evaluating a single non-serum bodily fluid sample of a subject to assess corpus luteum functionality, comprising: collecting the single non-serum bodily fluid sample; testing the single non-serum bodily fluid sample with a single test in the form of a lateral flow assay, the lateral flow assay comprising: a sample pad configured to receive a non-serum bodily fluid sample, a receiving zone within a conjugate pad, the conjugate pad saturated with a conjugate consisting of an anti-progesterone antibody or anti-progesterone metabolite antibody conjugated to colloidal gold, a fluorescent dye or colored latex beads, a test line within a membrane, the test line comprising a progesterone or a progesterone metabolite conjugated to a carrier protein and configured to evaluate for the presence of the progesterone metabolite at or above a threshold, the threshold selected from within the range inclusive of 3-20 μg/ml, or the presence of progesterone at or above a threshold selected from the range inclusive of 90-300 pg/ml, and an adsorbent pad at an end of the specially configured lateral flow assay opposite from the sample pad; repeating the collecting step and the testing step, for at least three days during the timeframe of 7-10 days past ovulation or until the first indication that the progesterone metabolite or progesterone is below the threshold of a single test, the first indication obtained by observing a label generated by operation of the single test and observable on the single test representing a negative result for the presence of the progesterone metabolite or progesterone at or above a threshold, recording the total number of days the presence of the progesterone metabolite or progesterone is indicated at or above the threshold of the single test prior to the first negative single test signaling that the progesterone metabolite or progesterone is below the threshold of the single test; and determining whether ovulation has occurred by evaluating for the presence of at least one positive result obtained by operation of the single test performed once daily during the timeframe of 7-10 days past ovulation for a progesterone metabolite or progesterone at the threshold of the single test as indicated by at least one single test.
 8. The method of claim 7, further comprising: deciding whether to avoid sexual intercourse based upon the interpretation of the results of the single test to lessen the risk of pregnancy; and engaging in sexual intercourse following a positive result indicated on the single test.
 9. The method of claim 7, the testing step taking place in conjunction with a reader comprising a cavity, the reader further comprising a carriage for at least a portion of the single test and adapted to receive at least a portion of the single test into the cavity, the single test of a configuration comprising dimensions corresponding to the cavity and placeable within said the cavity at a predetermined reading position, the reader further comprising a light source configured to shine a light onto the single test, and the reader further comprising a sensor to measure the reflected light from the single test to obtain a result.
 10. The method of claim 7, the single test further configured to detect the presence or absence of luteinizing hormone (LH) within a second testing zone.
 11. The method of claim 7, further comprising: deciding whether sufficient levels of progesterone to support pregnancy are present based upon the interpretation of the results of the single test, and following a negative result, testing blood to determine with precision the specific level of serum progesterone, and supplementing with additional progesterone.
 12. The method of claim 7, further comprising: determining that the corpus luteum is functioning properly if at least two of the single tests separately performed each on a distinct day during the timeframe of 7-10 days past ovulation each indicate a positive result for the presence of the progesterone metabolite or progesterone.
 13. A method for evaluating a series of samples of urine of a subject, each sample of the series collected daily during a period of at least three consecutive days during the timeframe of 7-10 days past the ovulation date, to evaluate corpus luteum function by estimating the levels of progesterone, comprising: predicting the three consecutive days to optimally conduct testing by a step from the group consisting of: a. testing urine with a lateral flow assay test configured to evaluate urine for the presence of luteinizing hormone to determine the ovulation date; b. measuring a rise in basal body temperature of at least 0.5 degrees Fahrenheit to determine the ovulation date; c. utilizing a menstrual cycle tracking application operating on a mobile device configured to determine the ovulation date; and d. sampling cervical mucus to determine the ovulation date; collecting a urine sample daily for three consecutive days during the timeframe of 7-10 days past the ovulation date; for each urine sample collected on each of the three consecutive days, testing for the presence of a metabolite of progesterone by evaluating the urine sample with a specially configured lateral flow assay, the specially configured lateral flow assay comprising: a sample pad configured to receive each urine sample, a receiving zone within a conjugate pad, the conjugate pad saturated with a conjugate consisting of an anti-progesterone metabolite antibody conjugated to a label, a test line within a membrane, the test line comprising a progesterone metabolite conjugated to a carrier protein and configured to evaluate for the presence or absence of the progesterone metabolite in the urine sample at or above a threshold, the threshold selected from within the range inclusive of 3-20 μg/ml, and further configured to generate an observable result by operation of the specially configured lateral flow assay by depicting a color within the test line if the progesterone metabolite is absent at the threshold in the urine sample or depicting a reduced or absent color within the test line if the progesterone metabolite is present at the threshold in the urine sample following the application of the urine sample, and an adsorbent pad at an end opposite from the sample pad; observing each test result obtained by operation of each specially configured lateral flow assay and demonstrated by the test line of the specially configured lateral flow assay, the test result indicating whether the urine sample contains an amount of the progesterone metabolite at or above the threshold; following the first indication of the presence of the progesterone metabolite at a concentration at or above the threshold in the urine sample on a performed specially configured lateral flow assay, repeating the collecting step and the testing step for each day during the timeframe of 7-10 days past the ovulation date; and recording the total number of days that the presence of the progesterone metabolite is indicated at or above the threshold during the timeframe of 7-10 days past the ovulation date.
 14. The method of claim 13, further comprising: deciding whether sufficient levels of progesterone necessary to support pregnancy are present based upon the results of the series of specially configured lateral flow assays.
 15. The method of claim 13, further comprising: following a negative result observed during the three consecutive days, testing blood to determine with precision the specific level of serum progesterone.
 16. The method of claim 13, further comprising: following a negative result observed during the three consecutive days, supplementing progesterone.
 17. The method of claim 13, further comprising: determining that the corpus luteum is functioning properly following at least two results indicating the presence of the progesterone metabolite at or above the threshold, each result obtained on a distinct day during the timeframe of 7-10 days past the ovulation date. 